Medical Claims Review Manager jobs in Corona, CA

Medical Claims Review Manager oversees the performance, productivity, and quality of the medical claims review staff. Responsible for hiring, training, and firing medical claims review staff. Being a Medical Claims Review Manager evaluates medical claims review processes and recommends process improvements. Serves as a technical resource for all medical review workers. Additionally, Medical Claims Review Manager typically requires an RN or BSN. Requires a bachelor's degree. Typically reports to a head of a unit/department. The Medical Claims Review Manager manages subordinate staff in the day-to-day performance of their jobs. True first level manager. Ensures that project/department milestones/goals are met and adhering to approved budgets. Has full authority for personnel actions. Extensive knowledge of department processes. To be a Medical Claims Review Manager typically requires 5 years experience in the related area as an individual contributor. 1 to 3 years supervisory experience may be required. (Copyright 2024 Salary.com)

K
Utilization Review LVN
  • KPC GLOBAL MEDICAL CENTERS INC.
  • Corona, CA FULL_TIME
    • Coordinates and reviews all medical records, as assigned to caseload
    • Actively participates in Case Management and Treatment Team meetings
    • Serves as on-going educator to all departments
    • Responsible for reviewing patient charts in order to assess whether the criteria for admission and continuation of treatment is being met; gathering data and responding to request for records from fiscal intermediary; gathering clinical and fiscal information and communicating status of both open and closed accounts for multiple levels of Utilization Review and Case Management reporting
    • Able to work independently and use sound judgment.
    • Knowledge of Federal, State, and intermediary guidelines related to inpatient, acute care hospitalization, as well as lower levels of care for the continuity of treatment.
    • Coordinates discharge referrals as requested by clinical staff, fiscal intermediary, patients, and families.
    • Performs other duties as assigned.
  • 19 Days Ago

K
Utilization Review LVN
  • KPC GLOBAL MEDICAL CENTERS INC
  • Corona, CA FULL_TIME
  • Coordinates and reviews all medical records, as assigned to caseloadActively participates in Case Management and Treatment Team meetingsServes as on-going educator to all departmentsResponsible for re...
  • 5 Days Ago

T
Workers Compensation Claims Examiner
  • TheBest Claims Solutions
  • Riverside, CA FULL_TIME
  • We are currently sourcing candidates for a Claims Examiner position. This position is direct-hire and remote. For this position we are looking for candidates with 3 years of experience handling Califo...
  • 12 Days Ago

C
CA Utilization Review Case Manager I
  • CorVel Brand
  • Rancho Cucamonga, CA FULL_TIME
  • The Utilization Review Case Manager gathers demographic and clinical information on prospective, concurrent and retrospective in-patient admissions and out-patient treatment, certifies the medical nec...
  • 15 Days Ago

I
Manager, Claims Processing - Covered California
  • Inland Empire Health Plan
  • Rancho Cucamonga, CA FULL_TIME
  • Overview What you can expect! Find joy in serving others with IEHP! We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to an authentic experien...
  • 1 Month Ago

F
Assistant Manager/ Medical Assistant
  • Fontana Medical Group
  • Murrieta, CA PART_TIME,FULL_TIME
  • Assistant Manager/ Medical Assistant Must have sales experience: Learn the product we have and sell to patients.Medical Assistant / Based on Experience employment type:Looking for an energetic, outgoi...
  • 30 Days Ago

Filters

Clear All

Filter Jobs By Location
  • Filter Jobs by companies
  • More

0 Medical Claims Review Manager jobs found in Corona, CA area

I
Medical Director, Medical Management
  • Imperial Health Plan of California, Inc.
  • Pasadena, CA
  • People are the most important asset of Imperial, for this reason the difference and plurality of people, equality of opp...
  • 4/23/2024 12:00:00 AM

L
Outpatient Child Psychiatrist - Hybrid schedule - Riverside, CA
  • LifeStance Health
  • Riverside, CA
  • At LifeStance Health, we believe in a truly healthy society where mental and physical healthcare are unified to make liv...
  • 4/22/2024 12:00:00 AM

L
Adult Psychiatrist - Riverside, CA
  • LifeStance Health
  • Riverside, CA
  • At LifeStance Health, we believe in a truly healthy society where mental and physical healthcare are unified to make liv...
  • 4/22/2024 12:00:00 AM

H
Remote Licensed Psychiatrist
  • Headway
  • Anaheim, CA
  • Remote Licensed Psychiatrist Wage: Between $148-$232 an hour Are you a licensed Psychiatrist looking to launch a private...
  • 4/21/2024 12:00:00 AM

I
Medical Director, Medical Management
  • Imperial Health Plan Of California Inc.
  • Pasadena, CA
  • People are the most important asset of Imperialfor this reason the difference and plurality of people, equality of oppor...
  • 4/21/2024 12:00:00 AM

H
Remote Licensed Mental Health Counselor
  • Headway
  • Anaheim, CA
  • Remote Licensed Mental Health Counselor (LMHC) Wage: Between $86-$130 an hour Are you a Licensed Mental Health Counselor...
  • 4/21/2024 12:00:00 AM

H
Remote Licensed Clinical Social Worker
  • Headway
  • Anaheim, CA
  • Remote Licensed Clinical Social Worker (LCSW) Wage: Between $86-$130 an hour Are you a Licensed Clinical Social Worker l...
  • 4/21/2024 12:00:00 AM

L
Psychiatric Nurse Practitioner - Anaheim, CA
  • LifeStance Health
  • Anaheim, CA
  • At LifeStance Health, we believe in a truly healthy society where mental and physical healthcare are unified to make liv...
  • 4/21/2024 12:00:00 AM

Corona is a city in Riverside County, California, United States. As of the 2010 census, the city had a population of 152,374, up from 124,966 at the 2000 census. The cities of Norco and Riverside lie to the north and northeast, respectively, Chino Hills and Yorba Linda to the northwest, and the Cleveland National Forest and the Santa Ana Mountains to the southwest, and unincorporated areas of Riverside County line all of its other borders. Corona lies approximately 48 miles (77 km) southeast of Los Angeles and 95 miles (153 km) north-northwest of San Diego....
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Medical Claims Review Manager jobs
$103,524 to $131,994
Corona, California area prices
were up 3.0% from a year ago

Medical Claims Review Manager in Paramus, NJ
Support management with leading Medical Review team to ensure all types of claims requiring medical reviews are completed in compliance with State, Federal, accreditation standards and other applicable regulations.
February 01, 2020
Medical Claims Review Manager in Nashua, NH
By truly combining claims and bill review, the two systems are kept in sync utilizing the scheduled jobs of the aforementioned standard model; however, for real-time data updates, claims examiners are granted access to the entire live bill review system.
January 13, 2020
Medical Claims Review Manager in Davenport, IA
Complex claim errors can only be caught by physician reviewers with the clinical experience to spot mistakes that automated systems can’t detect.
January 03, 2020